Comparative Effectiveness of Drug Treatments

September 15, 2003

Do consumers, employers and doctors lack the information needed to judge whether the drugs they're using are the most effective treatment? While some observers are calling for more government-sponsored studies of comparative treatment effectiveness, the industry points out that drug therapies are the most extensively studied area of medicine, since the Food and Drug Administration requires manufacturers to study both the effectiveness and safety of new drugs.

There is research that some new drugs are no more effective than lower-priced choices -- at least for some patients:

A federal study reported last year that children with middle-ear infections recovered just as well after treatment with common antibiotics as youngsters using more expensive brand-name products.

Oregon's state health plan last year found no evidence that the highly promoted painkillers Celebrex and Vioxx work better than over-the-counter ibuprofen, which can cost as little as 10 percent of the brand-name drugs' prices.

A study published in December found that an inexpensive, long-established diuretic was more effective than newer, costlier rivals in lowering blood pressure and preventing complications -- however, a more recent study produced somewhat different results.

Furthermore, one recent government-run comparative effectiveness study was contradicted by another study published three months later.

Different patients respond differently to medicines, say experts, whereas comparative studies focus on population averages, not individual patients. Such studies should not be used to limit patient choices, says the drug industry, because saving money (the aim of government-sponsored studies) should not come at the expense of quality of care.

Source: Editorial, "Industry Discourages Study of New Drugs," and Alan F. Holmer (PhRMA, the Pharmaceutical Research and Manufacturers of America), "Studies Come with Problems," USA Today, September 15, 2003.